“Argument in an Off Key.”[Public domain], via Wikimedia Commons

July 11, 2017; GeekWire

Like many nonprofits, providers of contraception and women’s health across the globe are scrambling to provide effective care for their constituents as their funding and support are being carved away by the current administration. Melinda Gates recently called attention to the issue—not by solving the problem, but precisely because even with all the money and power the Gates Foundation has, they’re unable to tackle the problem effectively without government cooperation.

Although data on global contraception use is spotty, the research showing the benefits of contraception access is solid. A World Health Organization (WHO) paper stated,

Family-planning promotion is unique among medical interventions in the breadth of its potential benefits: reduction of poverty, and maternal and child mortality; empowerment of women by lightening the burden of excessive childbearing; and enhancement of environmental sustainability by stabilizing the population of the planet.

Numerous organizations have shown positive effects on women’s education, children’s educational opportunities, and child survival, health, and nutrition. Even national GDP is affected, since, as the WHO notes, “In most developing countries, for instance, women’s participation in the labor force has increased as fertility has fallen.” Providing contraception is relatively cheap and scalable, since local clinics can administer and educate on different forms of birth control, and the outsize moral and socioeconomic benefits make it one of the most efficient and cost-effective ways to empower women and lift entire communities out of poverty.

Despite this reality, the Trump administration has shown itself hesitant to support women’s health and family planning access around the globe. NPQ documented earlier this year that the reinstated Mexico City Policy, which shuts off USAID funding to any organization that even mentions abortion to its constituents, “forces healthcare providers to make a choice between losing a large part of their budgets and providing what they consider suboptimal care.” Efforts to cut Planned Parenthood funding and the scary precondition classifications in the Senate “healthcare” bill threaten access to family planning in the U.S., while an understaffed state department has limited ability to cooperate with local governments and on-the-ground NGO workers to facilitate healthcare delivery in developing countries.

The Bill & Melinda Gates Foundation is committed to helping women make informed family planning decisions. They have a longstanding partnership with an organization called Family Planning 2020, to which they have already donated $1 billion. This year, the foundation promised “$375 million in funding over the next three years to expand access to contraceptives for some of the world’s poorest communities,” but the promise came with an odd, yet important, caveat.

Melinda Gates stated, “This additional funding won’t begin to fill the gap that proposed U.S. budget cuts could create.”

That’s right: The largest private foundation in the United States, whose assets and gifts are several times the size of the next largest contender, can’t come close to filling the gap left by an inactive government policy when it comes to a crucial issue like family planning.

The Gates Foundation is large, generous, and committed to data-driven solutions that tackle serious problems. But however large their budget, it’s not anywhere close to the giving power of an entire country, and they don’t have the leverage that a government does to encourage reluctant regimes and stagnant health infrastructure to support interventions like contraception access. According to VOA News,

The United States is by far the biggest donor to global family planning programs, giving $600 million this year. But Trump announced in April that he planned to withdraw financial support for the UN Population Fund, accusing it of using what he called “coercive” family planning practices, including providing abortions. The United Nations strongly rejected the claims.

Nigeria’s minister of budget and national planning, Zainab S. Ahmed, said, “Our economy cannot grow fast enough” to sustain the country’s projected population growth, if current birthrates continue. The Gates Foundation’s partner, Family Planning 2020, estimated that 214 million women worldwide do not have access to modern contraception tools. “In 2017, an estimated 308,000 women in developing countries will die from pregnancy-related causes, and 2.7 million babies will die in the first month of life,” FP2020 said, and many of those deaths could be prevented with exactly the kind of family planning and healthcare access that the Trump administration’s policies will limit.

Melinda Gates traveled the world to meet with women in developing countries and reported,

Everywhere I went…I met women who were getting pregnant too young, too old, and too often for their bodies to handle. I met women who were desperate not to get pregnant again because they couldn’t afford to feed or care for the children they already had. In Malawi, everyone I met knew someone who had died in pregnancy. In India, I asked a group of women if anyone had lost a child, and every single woman raised her hand.

This is an unacceptable state of affairs, especially because the solution to many of these problems is cheap and easy to deliver. The failure of the Trump administration to step up as a global health partner leaves a gap that even the largest and most well-intended NGO efforts cannot fill. While other countries are stepping into the gap, it behooves U.S. nonprofits to be mindful of Melinda Gates’ words and keep up the pressure for our government to do the right thing.—Erin Rubin